Posology : מינונים

4.2    Posology and method of administration
The following dosage instructions apply:
The smallest possible volume of solution which will lead to an
effective anaesthesia should be used.
For extraction of maxillary teeth, 1.7 ml Articaine HCl 4% and Epinephrine 1:200,000 per tooth suffices in most cases; painful palatal injections can thus be avoided. In the case of serial extractions of neighbouring teeth, a reduction of the injection volume is often possible.
If a cut or suture is required in the palate, a palatal injection of approx 0.1 ml per puncture is indicated.
For smooth extractions of mandibular premolar teeth, infiltration anaesthesia of 1.7 ml Articaine HCl 4% and Epinephrine 1:200,000 per tooth is mostly sufficient; in single cases a buccal re-injection of 1 to 1.7 ml is required. An injection into the mandibular foramen can be indicated in rare cases.
Vestibular injections of 0.5 - 1.7 ml Articaine HCl 4% and Epinephrine 1:200,000 per tooth enable cavity and crown-stump preparations.
Nerve-block anaesthesia should be used in the treatment of mandibular molar teeth.
Generally, in children weighing about 20 - 30 kg, doses of 0.25 - 1 ml are sufficient; in children weighing 30 - 45 kg, 0.5 - 2 ml.
Articaine HCl 4% and Epinephrine 1:200,000 must not be used with children aged under 4 years (see section 4.3).
Increased plasma levels of Articaine HCl 4% and Epinephrine 1:200,000 can occur in older patients due to diminished metabolic processes and lower distribution volume. The risk of accumulation of Articaine HCl 4% and Epinephrine 1:200,000 is increased in particular after repeated application (e.g.
re-injection). A similar effect can ensue from the reduced general condition of the patient, as well as severely impaired hepatic and renal function (see also section 4.4).
A lower dosage range is thus recommended in all such cases (minimum quantity for sufficient anaesthetic depth).
The dose has to be likewise reduced in patients with certain pre-existing diseases (angina pectoris, arteriosclerosis) (see also section 4.4).
Maximum Recommended Dosage:
Adults:
For healthy adults, the maximum dose is 7 mg/kg body weight articaine (500 mg for a 70 kg patient), equivalent to 12.5 ml Articaine HCl 4% and Epinephrine 1:200,000.
The maximum dose represents 0.175 ml of solution per kg.
Children:
The quantity to be injected should be determined by the age and weight of the child and the magnitude of the operation. Do not exceed the equivalent of 7 mg articaine/kg (0.175 ml Articaine HCl 4% and Epinephrine 1:200,000 /kg) of body weight.
Espestesin 4 % articaine with 1/100:000 adrenaline (epinephrine) is also available and may be more appropriate for procedures of longer duration and when there is a risk of significant bleeding into operative field (see section 5.1 for more information on duration of analgesia).
Method of administration
For injection/oromucosal use
FOR USE IN DENTAL ANAESTHESIA ONLY

To avoid intravascular injection, aspiration control at least in two planes (rotation of the needle by 180°) must always be carefully undertaken, although a negative aspiration result does not safely rule out an unintentional and unnoticed intravascular injection.
The injection rate should not exceed 0.5 ml in 15 seconds, i.e. 1 cartridge per minute.
Major systemic reactions as a result of accidental intravascular injection can be avoided in most cases by an injection technique – after aspiration slow injection of 0.1 – 0.2 ml and slow application of the rest – not earlier than 20 – 30 seconds later.
Opened cartridges must not be used in other patients. Residues must be discarded.